cerebrovascular history and physical

  1. What are three reasons why a Bruit is heard?
    • 1. stenosis
    • 2. tortuous vessels
    • 3. valves-stenosis
  2. Is a Bruit symptomatic or asymptomatic?
  3. What is the difference between TIA and CVA?
    TIA lasts less than 24 hours and usually only lasts minutes.

    CVA lasts greater than 24 hours and causes a permanent neurological damage.
  4. TIA stand for what?
    Transient Ischemic Attach
  5. CVA stands for what?
    Cerebrovascular Accident
  6. Is TIA symptomatic or asymptomatic?
  7. Is CVA symptomatic or asymptomatic?
  8. What is the chance of a CVA occurring after a TIA within 3 months?
    10 %
  9. What is the chance of a CVA occurring after a TIA within the first 2 days after the initial symptoms?
    50 % or a half of CVA occur within 2 days of a TIA.
  10. What does RIND stand for?
    Reversible Ischemic Neurologic Deficit
  11. Is RIND symptomatic or asymptomatic?
  12. What are the six causes of strokes?
    • 1.) Atherosclerosis
    • 2.) Embolism from the heart
    • 3.) Hypertension
    • 4.) Dissection
    • 5.) Pre-thrombotic (Deficiencies in        prothrombin
    • 6.) Vasopasm
  13. How does Atherosclerosis cause strokes?
    Hemodynamically significant. (Blood flow is being restricted and changed)

    75% area reduction

    50% diameter reduction of lumen
  14. How does Embolism from the heart cause a stroke?
    Causes a Cardioembolic stroke

    • An arrhythmia of Lt. Atrium, atrial fibrillation, prosethic heart valve,
    • damaged cardiomyopathy, mitral stenosis, bacterial endocarditis
  15. How does Hypertension cause a stroke?
    Injury to small vessels, puts stress on arteries.
  16. How does Dissection cause a stroke?
    False lumen, narrows true lumen

    (Carotid A. or Vertebral A.)
  17. What does Pre-thrombotic cause a stroke?
    Proteins C or S deficiency

    Antithrombin 3 deficiency
  18. What does Vasospasm cause a stroke?
    Head injuries

    Subarachnoid hemorrhage (SAH)- Have vasospasm which is a problem after a hemorrhage.

    muscle contracts, reduces blood flow
  19. What is the anterior circulation also called?
    Carotid Circulation
  20. What arteries does the anterior circulation include?
    • 1.) ICA
    • 2.) MCA's
    • 3.) ACA's
  21. What are 6 signs and symptoms of the anterior circulation?
    • 1.) Monocular visual disturbance
    • 2.) Amaurosis Fugax
    • 3.) Aphasia
    • 4.) Mono or hemiparesthesia
    • 5.) Mono or hemiparesis
    • 6.) Homonymous hemianopia
  22. What sign and symptoms can be considered part of both the anterior and posterior circulation?
    Homonymous hemianopia
  23. What vessels are involved in the posterior circulation?
    • 1.) PCA
    • 2.) Vertebrals
    • 3.) Basilar
  24. What are the 9 signs and symptoms of posterior circulation?
    • 1. Homonymous hemianopia
    • 2. Paraesthesias of any or all extremities
    • 3. Paresis of any or all extremities
    • 4. Ataxia
    • 5. Drop attacks
    • 6. Diplopia
    • 7. Dysphagia
    • 8. Dysarthria
    • 9. Vertigo
  25. What are 6 non-specific sign or symptoms?
    • 1. confusion
    • 2. dizziness
    • 3. headache
    • 4. impaired mental status
    • 5. loss of memory
    • 6. syncope
  26. What is monocular visual disturbance?

    What should be checked when monocular visual disturbance?
    Transient or complete loss of vision in one eye.

    Check ICA and Ophthalmic A. on the same side as the eye with problems.
  27. Amaurosis Fugax can be considered the same as ________________ but with a difference because of _______________.
    same as Monocular visual disturbance

    is a Emboli problem
  28. What is Amaurosis caused by?

    Described as?

    Check what?
    Vision loss due to a temporary reduction in retinal artery or ophthalmic artery blood flow which causes retinal hypoxia.

    Described as Shade pulled over eye.

    Check ICA and ophthalmic A. on the same side as symptoms.
  29. What is Aphasia?
    without speech or unable to communicate.
  30. What is Homo or hemiparesthesia?

    What to check?
    1-sided numbness, tingling sensation

    check the opposite side as problem.
  31. What is Mono or hemiparesis?
    1-sided paralysis
  32. What is homonymous hemianopia?
    Partial loss of visual field in both eyes.
  33. What is Paraesthesia of any or all extremities?
    a numbness or tingling sensation "pins or needles" or "falling asleep" caused by a reduction in blood supply to nerves.

    • Can be:
    • both arms,
    • one arm and one leg,
    • both legs
  34. What is paresis of any or all extremities?
  35. What is Ataxia?
    Gait disturbance or touch an article with the hand.
  36. What is Drop Attacks?
    Sudden musculature weakness, do not lose consciousness.
  37. What is Diplopia?
    "Double Vision" or Bilateral visual blurring

    too images from one object
  38. What is Dysphagia?
    Difficulty swallowing
  39. What is Dysarthria?
    When there is difficultly speaking and pronouncing words due to problems with the muscles that help people talk.
  40. What is vertigo?
    More than just a dizziness feeling.

    It is a spinning sensation
  41. What are the 5 Different Types of Aphasias?
    • 1.) Auditory
    • 2.) Motor or Broca's
    • 3.) Visual
    • 4.) Sensory
    • 5.) Global
  42. What is specific about "Auditory Aphasia"?
    "word deafness"

    an impairment in understanding spoken language that is not attributed to hearing loss.
  43. What is specific about "Motor" or "Broca's Aphasia"?
    Have difficulty communicating orally and in writing.
  44. What is specific about "Visual Aphasia"?
    "Word blindness"

    Inability to perceive written words.
  45. What is specific about " Sensory Aphasia"?
    have problems understanding spoken and written language.
  46. What is specific about "Global Aphasia"?
    People have difficulty both expressing and understanding written and oral communication.
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cerebrovascular history and physical